The candidate for this K23 Mentored Patient-Oriented Research Career Development Award is a research fellow advancing to a junior faculty position. The candidate's long-term goal is to have an academic research career in pediatric diabetes to develop and enhance effective, empirically-supported methods for improving health outcomes and quality of life for children, adolescents, and their families. Specific short-term career goals to be achieved with this award include: 1) to develop an expertise in research methodologies to better understand the impact of emotional functioning of youth and their families on the management and health outcomes associated with type 1 diabetes, 2) to focus on depression in youth with type 1 diabetes and identify the factors predictive of depression in youth with type 1 diabetes, 3) to delineate modifiable factors for intervention and / or prevention in order to prepare an R01 application with a focus on intervention and prevention of depression in children and adolescents with type 1 diabetes. To achieve these goals, the candidate proposes a five-year training program. The candidate's primary mentor has a strong background in pediatrics and epidemiology that forms the basis for her research and clinical interests in preserving the health, and sustaining normal growth, development, and family functioning for children, adolescents, and young adults with diabetes. The mentorship team includes faculty members with expertise in behavioral, biologic, and epidemiologic areas as they relate to pediatric diabetes. Training activities include coursework in advanced research methodology, didactic instruction from mentors, and participation in research seminars. The proposed research plan for this award includes two studies. Study 1 is an examination of methods for assessing depression in youth with type 1 diabetes. Further, through a diagnostic interview, Study 1 will document the prevalence of depression in a large sample of children and adolescents with type 1 diabetes and document factors associated with depression. Study 2 is a longitudinal examination of the links between depression, adherence, and glycemic and health outcomes of these youth. Latent growth modeling with mediational analyses will provide valuable data on the links between depression, adherence, and glycemic outcomes in youth with type 1 diabetes. Findings from this research have the potential to impact the health and quality of life of children and adolescents with type 1 diabetes and their families.